Child Behaviour Problems Research Articles

A randomised controlled trial of the Group Stepping Stones Triple P training programme for parents of children with developmental disabilities.

The central aim of this study was to examine the effectiveness of Group Stepping Stones Triple P (GSSTP) in an Irish context for families of children with both developmental disabilities and internalising and externalising behavioural problems. Parents of 84 children (mean age = 5.73; SD = 2.06) with developmental disabilities and co-occurring behaviour problems attending Irish public health services were randomly assigned to a 9-week GSSTP group or a waiting list control (WLC) group. All parents completed self-report measures before (Time 1) and after (Time 2) the programme and parents in the GSSTP group were assessed at 3- to 5-month follow-up (Time 3). At Time 2, clinical improvement and reliable change rates on the primary dependent variables (summary scales of the Developmental Behaviour Checklist and Strengths and Difficulties Questionnaire) were significantly higher in the GSSTP group than in the WLC group. At Time 2, mean scores of the GSSTP group showed significant, small to medium improvements relative to the WLC group on parent-reported child behaviour problems, parenting skills and confidence, and parental adjustment. Most of these improvements were maintained at 3- to 5-month follow-up. These results indicate that GSSTP is a promising intervention for improving child behaviour and parenting outcomes in a mixed-disability group in an Irish context.

Assessment of Disruptive Behaviour Disorder, Academic Performance, and School Social Behaviour of Children

In the present study, academic performance, childhood behaviour problems, Social Competence and Antisocial Behaviour of children screened out with symptoms of either Attention Deficit Hyperactivity Disorder (ADHD), Oppositional Defiant Disorder (ODD), Conduct Disorder (CD) or comorbid disorders as compared to the comparison group of children (without symptoms of ADHD, ODD, and CD) was explored. Sample included children of 3rd to 5th grades between age range 8 to 13 years (N = 806; Mean age = 9.55, SD = 1.27) including (boys n = 453; Mean age = 9.65, SD = 1.19) and (girls n = 353; Mean age = 9.43, SD = 1.35) from different schools of Islamabad and Rawalpindi. Disruptive Behaviour Disorder (DBD) Rating scale (Urdu version: Loona & Kamal, 2011) and School Social Behaviour Scale (SSBS) (Urdu version: Loona & Kamal, 2002) along with Consent Form were presented to the respective class teachers. Findings showed higher number of children with symptoms of DBD falling in the academically low scoring group. Moreover, findings indicated children with middle and low academic performance scored high on Antisocial Behaviour subscale of SSBS as compared to high scorer group.

Change in Mothers’ Perception of Well-being and Distress following Treatment of Child Conduct Problems

Raising children with conduct problems represents a special challenge, and parents of these children often experience parenting stress and develop other adjustment problems of their own. However, there is little knowledge as to how participation in treatment influences parental adjustment problems, for instance parental experience of stress and well-being. The aim of this study is to investigate possible changes in mothers’ perception of well-being and distress over the course of the treatment of child conduct problems. The study used mothers’ reports from two interconnected studies of PMTO in Norway, a randomized controlled study, and a large-scale implementation study. The levels of psychological stress were high, both in terms of general symptoms of anxiety and depression, and problems with everyday functioning indicating stress that is more chronic. Several measures of well-being and distress showed significant change over the period from intake to post treatment. The changes were significantly related to perceived change in children’s conduct problems (all p < .05), but this only predicted a small part of the variance (all ΔR2 < .03). The result indicates that mothers’ involvement in the treatment of their child’s conduct problems results in beneficial effect on mothers’ perception of well-being and distress, regardless of treatment condition. Other factors that alter children’s conduct problems are responsible for this change. Interpretations and potential implications of the findings are discussed.

RETRACTED ARTICLE: The Quintessence of Child Conduct Problems: Identifying Central Behaviors through Network Analysis

Child conduct problems are generally treated as a latent construct or as an additive index, where indicators are considered equally reflective indicators, in line with the “common cause hypothesis”. The current study presents a third alternative, where conduct problems constitute behaviors that associate and interact, in terms of a multivariate network structure. The aims of the study were to investigate the network structure of conduct problems and reveal strongly connected and central behaviors. Child gender and age were included into the analyses to uncover how these relate to the specific behaviors. The sample comprised of parent-reported data of 551 Norwegian children (age 3–12) with moderate to high levels of conduct problems, who reported intensity of 22 behaviors using the Eyberg Child Behavior Inventory. The research questions were examined by estimating a correlational and partial correlational LASSO network of conduct problems. Results showed that behaviors in general were positively connected. The majority of behaviors clustered into two distinct domains, reflecting inattention and oppositional defiant behavior. Furthermore, results showed that behaviors showed differential centrality, i.e., not all behaviors were equally important to the conceptualization of child conduct problems. Implications of the results for assessment and intervention are discussed.

A systematic review of tools used to screen and assess for externalising behaviour symptoms in low and middle income settings.

Mental health issues, often manifested as behavioural difficulties, in children are estimated to be high in low and middle-income countries (LMIC) settings. There is a paucity of definitive data due to a lack of well-validated tools to use across settings. This review aims to provide evidence on what tools are used and which have been adapted and validated in LMIC settings. We performed a systematic review to identify tools used to assess or screen externalising behaviour problems in children and adolescents in LMIC and assess their cultural adaptations. We searched for studies measuring externalising behaviour in children from 0 to 19 years published up to September 2018. Articles were assessed to identify tools used and analysed using the Ecological Validity Framework. We identified 82 articles from over 50 LMICs who had studied externalising behaviour in children. Twenty-seven tools were identified, with a predominance of studies using tools from the USA and Europe. Most studies did not describe an adaptation and evaluation process, with only one study following recommended criteria. New tools were identified which both screen and assess externalising behaviour which have not yet been utilised across settings. Although tools from the USA and Europe are often utilised to screen and assess for externalising behaviour problems in children in LMICs, the conceptual frameworks behind the use of these tools in other cultural contexts are not always carefully examined. In order to have valid data across cultures, we should aim to adapt and validate tools before use. Provision of processes to validate tools across LMIC settings would be beneficial.

Early growth in expressive communication and behavior problems: Differential relations by ethnicity

The current study examined the association between early growth in expressive communication from 18 months (1.5 years: M = 1.59 years, SD = 0.08 years) to 36 months (3 years: M = 3.01 years, SD = 0.05) and internalizing and externalizing problems at 84 months (8 years: M = 7.79 years, SD = 0.31) and the differences in this association by ethnicity. We hypothesized that lower rates of early expressive communication growth from 18 to 36 months would be associated with more behavior problems in childhood, and that this association would be stronger for African American than European American children. The sample included 206 full-term healthy African American and European American children from the Durham Child Health and Development Study. Parents reported family demographics and children’s internalizing and externalizing behaviors via questionnaires, while children completed language assessments in the laboratory. Hierarchical regression analyses revealed a significant interaction between growth in expressive communication and ethnicity for internalizing but not externalizing behavior, such that lower rates of expressive language growth were associated with increased internalizing behavior among African American children, but not among their European American peers. These findings suggest that the well-being of children from marginalized ethnic backgrounds may be disproportionately affected by reduced rates of language development, and that the provision of educational or clinical services for African American children in particular should consider the link between language skills and social and emotional well-being.

Prevention of child mental health problems in Southeastern Europe: a multicentre sequential study to adapt, optimise and test the parenting programme ‘Parenting for Lifelong Health for Young Children’, protocol for stage 1, the feasibility study

IntroductionFamilies in low-income and middle-income countries (LMICs) face multiple challenges (eg, poverty and adverse childhood experiences) that increase the risk for child mental health problems, while the context may provide...

Association of Maternal and Paternal Depression in the Postnatal Period With Offspring Depression at Age 18 Years

Paternal depression during the postnatal period has been associated with adverse child outcomes. Family environment has been reported as a pathway for risk transmission from fathers to children. The influence of paternal depression during the postnatal period on offspring depression remains to be clarified. To investigate the association between paternal depression in the postnatal period and offspring depression and explore potential mediating and moderating factors that influence any association between paternal and offspring depression. This prospective study of a UK community-based birth cohort (the Avon Longitudinal Study of Parents and Children) of parents and their adolescent offspring investigated associations between paternal depression during the postnatal period and offspring depression at age 18 years. We tested a hypothesized moderator (ie, sex) and conducted path analysis to examine hypothesized mediators (ie, depression in the other parent, couple conflict, and paternal involvement and emotional problems, conduct problems, and hyperactivity in offspring at age 3.5 years) of the associations between both paternal and maternal depression and offspring depression. Data collection for the Avon Longitudinal Study of Parents and Children began in 1991 and is ongoing. Data analysis for this study was conducted from June 2015 to September 2018. Depression symptoms in fathers at 8 weeks after the birth of their children. Offspring depression symptoms at age 18 years, using International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes. A total of 3176 father-offspring pairs were analyzed; of the children, 1764 were girls (55.5%) and 1412 (44.5%) were boys. Paternal mean (SD) age at delivery was 29.6 (9.6) years. The offspring of fathers who had depression during the postnatal period were at increased risk of experiencing depression symptoms at age 18 years (β = 0.053 [95% CI, 0.02-0.09]). The association is mediated by maternal depression at 8 months after birth (β = 0.011 [95% CI, 0.0008-0.02]; 21% [0.011/0.053]) and conduct problems at 42 months after birth (β = 0.004; [95% CI , -0.00004 to 0.009]; 7.5% [0.004/0.053]). Couple conflict and paternal involvement do not mediate this association. The increased risk is seen in girls but not boys (interaction β = 0.095; P = .01). The association between paternal depression in the postnatal period and depression in girls at age 18 years is partially explained by maternal depression. Couple conflict and paternal involvement were not found to play a role in the risk of transmission; this contrasts with the role that couple conflict was found to play in the risk of childhood behavior problems. Conduct problems in childhood appear to be a pathway for risk transmission between paternal depression and subsequent depression in offspring at age 18 years.

Early childhood predictors of boys' antisocial and violent behavior in early adulthood.

Research on early childhood predictors of violent behaviors in early adulthood is limited. The current study investigated whether individual, family, and community risk factors from 18 to 42 months of age were predictive of violent criminal arrests during late adolescence and early adulthood using a sample of 310 low-income male participants living in an urban community. In addition, differences in trajectories of overt conduct problems (CP), hyperactivity/attention problems (HAP), and co-occurring patterns of CP and HAP from age 1½ to 10 years were investigated in regard to their relationship to violent and nonviolent behaviors, depression, and anxiety at age 20. Results of multivariate analyses indicated that early childhood family income, home environment, emotion regulation, oppositional behavior, and minority status were all significant in distinguishing violent offending boys from those with no criminal records. In addition, trajectories of early childhood CP, but not attention deficit hyperactivity disorder, were significantly related to self-reports of violent behavior, depressive symptoms, and anxiety symptoms. Implications for the prevention of early childhood risk factors associated with adolescent and adult violent behavior for males are discussed.

Association of language, behavior, and parental stress in young children with a language disorder

BackgroundSeveral studies show that language problems, child behavior problems, and parental stress can co-occur in children. Still, little is known about how these domains are related in toddlers with a language disorder (LD). AimsThis study examined relations between language problems, child behaviour problems, and parental stress in toddlers with LD and if these relations differ for children with different types of LD. MethodData of 185 children with LD (mean age 38 months) were collected using Routine Outcome Monitoring. Children were divided into two groups: presence of receptive and expressive problems (REP) and expressive problems only (EP). Relations were analyzed using Structural Equation Modeling. ResultsA better receptive language was associated with less teacher-reported internalizing and externalizing problems. A better expressive vocabulary was associated with more parent-reported internalizing problems and more teacher-reported externalizing problems. No relation was found between language and parental stress. Associations between language, behavior, and parental stress did not differ for children with REP or children with EP. ConclusionsOur study shows that when specific language domains are examined, the pattern of associations between language and behavior becomes more complex, because relations exist between specific language domains and behavior, but not between all of them.

Correction to: Parents’ Instrumental use of Media in Childrearing: Relationships with Confidence in Parenting, and Health and Conduct Problems in Children

The original version of this article unfortunately contained a mistake. The presentation of Table 3 was incorrect. The corrected table is given below.

The Effect of Childhood Conduct Problems on Early Onset Substance Use: An Examination of the Mediating and Moderating Roles of Parenting Styles.

This study examines the role that effective parenting plays in the relationship between childhood conduct problems and the early onset of drug use. Effective parenting is posited to have a direct protective effect on drug use, a moderating effect on the relationship between conduct problems and early onset, and mediate the relationship between conduct problems and early onset. Two-generational panel data are used to examine these relationships among 263 parent–child dyads. Support is found for the direct protective effect of effective parenting on early onset .and for a partial mediating effect of parenting in the relationship between conduct problems and early onset. There was no support found for parenting moderating the risk that is posed by having childhood conduct problems. Implications for preventing childhood conduct problems from resulting in early onset of drug use through enhancing efforts to help parents cope with such problems are discussed.

Parents\u2019 Instrumental use of Media in Childrearing: Relationships with Confidence in Parenting, and Health and Conduct Problems in Children

Using an online questionnaire among 516 Dutch parents (children between 1 and 12 years; 68% mothers, 18% single parents) this study explored whether parents see media devices as useful tools in childrearing, and how parent-family characteristics and parental perceptions on parenting, media effects and child development predict the acceptance of instrumental media use. Findings revealed that parents saw media as a) a distractor providing the parent relief in childrearing, b) a babysitter when the parent is unavailable, and c) a tool to modify children’s behavior. Whereas 20 to 30 percent found media useful as a modifier or babysitter, only about 10 percent perceived media helpful as a distractor. Acceptance of the different types of instrumental media use depended more on parental perceptions than on parent-family variables: i.e., instrumental use of media was primarily endorsed by parents who are less confident about their parenting, have less support from a partner, expect positive effects from the media, and report health and conduct problems in their children.

The role of parental attributions in predicting parenting intervention outcomes in the treatment of child conduct problems

BackgroundParent attributions about the causes of their children's behaviour problems are a known predictor of problematic parenting and ongoing child problems. However, their importance in parenting interventions remains unknown as research has not addressed whether parental attributions predict outcomes associated with parenting training. The current study examined whether problematic pre-treatment and change resistant parental attributions during treatment uniquely predict child behaviour outcomes. MethodParticipants were 250 families with children aged from 3 to 16 referred to specialist clinics for the treatment of conduct problems. Measures of family demographic information, parental attributions, and severity of child conduct problems were collected as part of pre-treatment, post-treatment, and 3-month follow-up assessments. ResultsLinear regression showed that mothers' pre-treatment parental attributions uniquely predicted severity of conduct problems at the post-treatment and 3-month follow-up assessments. Fathers' pre-treatment parental attributions uniquely predicted severity of conduct problems at the 3-month follow-up assessment. Reductions in problematic pre-treatment parental attributions were recorded at post-treatment for both parents. However, smaller reductions or increases in mothers’ problematic attributions uniquely predicted worse child behaviour outcomes, a result not replicated for fathers. ConclusionsFindings that pre-treatment and change resistant parental attributions predict poorer child behaviour outcomes after controlling for other predictors and treatment effects recommend that parental attributions should be assessed prior to and after treatment and possibly included in treatment to maximise treatment gains for children with conduct problems.

Using Early Childhood Behavior Problems to Predict Adult Convictions.

The current study examined whether teacher and parent ratings of externalizing behavior during kindergarten and 1st grade accurately predicted the presence of adult convictions by age 25. Data were collected as part of the Fast Track Project. Schools were identified based on poverty and crime rates in four locations: Durham, NC, Nashville, TN, Seattle, WA, and rural, central PA. Teacher and parent screening measures of externalizing behavior were collected at the end of kindergarten and 1st grade. ROC curves were used to visually depict the tradeoff between sensitivity and specificity and best model fit was determined. Five of the six combinations of screen scores across time points and raters met both the specificity and sensitivity cutoffs for a well-performing screening tool. When data were examined within each site separately, screen scores performed better in sites with high base rates and models including single teacher screens accurately predicted convictions. Similarly, screen scores performed better and could be used more parsimoniously for males, but not females (whose base rates were lower in this sample). Overall, results indicated that early elementary screens for conduct problems perform remarkably well when predicting criminal convictions 20years later. However, because of variations in base rates, screens operated differently by gender and location. The results indicated that for populations with high base rates, convictions can be accurately predicted with as little as one teacher screen taken during kindergarten or 1st grade, increasing the cost-effectiveness of preventative interventions.

Effects of the Family Check-Up on reducing growth in conduct problems from toddlerhood through school age: An analysis of moderated mediation.

The Family Check-Up (FCU) is a preventive intervention found to significantly reduce child conduct problems (CP). This study examined the extent to which parents reported that their child's CP were a problem for them at baseline (baseline CP) as a moderator of FCU effects into middle childhood and moderated mediation models to explore positive parent-child dyadic interaction and maternal depressive symptoms as mediators. Participants included 731 mother-child dyads followed from child ages 2 to 9.5 (49% female; 28% African American, 50% European American, 13% biracial, and 9% other; 13% self-reported as Hispanic), with half assigned to the FCU. Maternal depressive symptoms, observed parent and child behavior (positive dyadic interaction), and CP were assessed annually. Support was found for baseline CP as a moderator of the FCU, with significant decreases in CP for children in the FCU demonstrating high baseline CP. The following associations did not differ between those with high versus low baseline CP. The FCU significantly increased positive dyadic interaction. Lower maternal depressive symptoms were associated with significantly lower CP. Findings add to existing evidence that preventive interventions are effective for high-risk families, and the FCU is especially beneficial for children whose parents report high levels of CP in early childhood. Further, the FCU significantly improved positive dyadic interaction for families of children with both high and low baseline CP. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Do Parenting Interventions Increase Social Inequalities in Child Conduct Problems? Pan-European Individual Participant Data (IPD) Meta-Analysis

Background: Childhood conduct problems are a costly public health problem, five times more common in socially disadvantaged groups. Untreated, they have a poor prognosis, with increasing gaps between socio-economic groups, and high rates of subsequent criminality. The Incredible Years (IY) is a high-quality parenting programme as recommended by NICE for reducing conduct problems, and is widely disseminated in Europe. Many trials show IY to be effective, but the potential effects on social inequality of parenting interventions are unknown. This matters since some behavioural interventions (e.g. smoking cessation programmes), while beneficial overall, can widen inequality gaps. Since single trials and aggregate-level meta-analysis are ill-equipped for examining differential intervention (moderator) effects, we pooled individual-level trial data. Method: Individual participant data (IPD) meta-analysis of a near-complete set of randomised trials of European IY parenting programmes (N=1696; 15 trials eligible; 7% [1/15], data unavailable; 7% [1/15] lacked primary outcome). Children were aged 2-10 years (M 5.1; 30% [492/1651] ethnic minority; 58% [931/1614] low-income). Primary outcome was child conduct problems, using Eyberg Child Behavior Inventory (ECBI-I). Moderators were analysed using multilevel modelling with multiple imputation. Findings: IY led to an overall reduction in child conduct problems (13.5 points on ECBI-I, 95% CI 10.9 to 16.1). There was no evidence for differential effects by family disadvantage (poverty, lone/teen parenthood, joblessness; low education), or ethnic minority status. Interpretation: This world-first IPD meta-analysis of parenting trials, the largest pooled data set to date, found no evidence for differential effects by social disadvantage, suggesting IY is unlikely to widen socioeconomic inequalities in conduct problems. Furthermore, the programme may be an important tool for reducing social disparities and improving poor long-term outcomes in disadvantaged families, since follow-up studies indicate that benefits persist. Clinicians and commissioners can be reassured the programme is similarly effective for families from different backgrounds

Coaching mothers of typical and conduct problem children in elaborative parent-child reminiscing: Influences of a randomized controlled trial on reminiscing behaviour and everyday talk preferences

This study compared the effects of mother-child reminiscing coaching on mothers of typically developing children (community sample) and mothers of children with conduct problems (clinical sample). It also tested whether intervention effects generalize to mothers' preferences for elaborative and mental-state oriented talk with their children in other contexts. Mother-child dyads (n = 88) in each sample were randomly allocated to condition: reminiscing intervention or active control. Pre-intervention, sample differences emerged. Mothers in the community sample were more elaborative during reminiscing than mothers in the clinical sample, and also expressed stronger preferences for elaborative talk in everyday contexts. Post-intervention, an intervention effect emerged. In both the community and clinical samples, mothers who had participated in the elaborative reminiscing intervention were more elaborative and emotion-focused during reminiscing than mothers in the active control condition. They also increased their preferences for elaborative and mental-state-oriented language in everyday contexts. While the mothers in the community sample remained more elaborative than mothers in the clinical sample, both experienced equivalent intervention gains. These findings highlight the value of reminiscing coaching for changing mothers’ interactional preferences and behaviours.

Parental satisfaction with caregiving among parents of children with autism spectrum disorders, attention deficit and hyperactivity, intellectual disabilities and typically developing

ABSTRACTBackground: Parenting of children with Developmental Disabilities is considered to be a challenging task. This group of parents are at risk for lower levels of being satisfied with caregiving to their child compared to parents of typically developing children.Methods: Participants were recruited from different services in four provinces across Iran to shape a larger research sample. The Parental Satisfaction with Caring for a child with Developmental Disability Index (PSCDDI) was utilized.Results: Parents of children with DDs particularly parents of children with ASD demonstrated decreased parental satisfaction with caregiving compared with parents of typically developing children. Child behaviour problems, gender and age emerged as a significant predictor of the level of parental satisfaction with caregiving.Conclusions: These findings suggest that understanding parental satisfaction with caring is an important factor in understanding the challenges associated with caring for a child with DD.

Paternal psychological distress, parenting, and child behaviour: A population based, cross-sectional study.

Child behaviour problems are common and can lead to later mental health problems. Poor maternal mental health and adverse parenting practices are known risk factors for child behaviour problems. Less is known about the association between paternal mental health and parenting, and child behaviour. We aimed to explore the association between paternal psychological distress and parenting (harsh discipline, low warmth, unreasonable expectations, and overinvolved/protectiveness) with children's internalising and externalising behaviour at 3years of age. Cross-sectional surveys of 669 (80% response) fathers of 3-year-old children, nested within a randomised controlled trial. Main outcomes of behaviour (Child Behavior Checklist), parenting (Parent Behavior Checklist and overinvolved/protective parenting scale), and psychological distress (Kessler-6) were measured. Regression modelling examined the associations between paternal factors and child behaviour, adjusting for maternal mental health and parenting, as well as child and family variables. In adjusted analyses, paternal psychological distress (b=0.43, 95% confidence interval [CI] [0.26-0.60], p<0.001), harsh discipline (b=0.20, 95% CI [0.13-0.27], p<0.001), and maternal mental health (b=0.08, 95% CI [0.03-0.12], p=0.001) were associated with externalising symptoms. However, only paternal psychological distress, harsh discipline, and being a boy were associated with borderline/clinical levels of externalising problems (all p<0.05). Paternal psychological distress, harsh discipline, overinvolved parenting, maternal mental health, and difficult child temperament were associated with internalising symptoms (all p<0.05). However, only paternal harsh discipline and overinvolved parenting were associated with borderline/clinical internalising problems. Paternal mental health and parenting are independently associated with child behaviour. Treatments for children with behavioural problems should also address paternal mental health and parenting.